| NPI | 1578835757 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1041C0700X Social Worker Clinical (Licence: MI 6801093260) |
| Additional Taxonomies | 101YP2500X Counselor Professional (Licence: CA 63746) |
| 103K00000X Behavior Analyst (Licence: CA 63746) | |
| 1041C0700X Social Worker Clinical (Licence: CA 63746) | |
| 1041S0200X Social Worker School | |
| 101YM0800X Counselor Mental Health | |
| 101Y00000X Counselor | |
| Enumeration Date | 2012-02-02 |
| Last Update Date | 2023-11-20 |